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The Totnes Cancer Health Centre: A Quack Pascal’s Wager

England has a rather odd piece of legislation prohibiting the advertisement of cancer treatments. It is odd because, on the whole, England is a pretty tolerant place when it comes to allowing people to set themselves up with health businesses. There is a Common Law right to practice. And anyone can treat a sick person, even for money, as long as there is informed consent.

There are exceptions. You must not claim you are a registered medical practitioner, you may not use a few protected titles such as Dietician and Speech Therapist, and you must not claim to be able to treat cancer and venereal disease.

The Cancer Act of 1939 specifically prohibits that “No person shall take any part in the publication of any advertisement containing an offer to treat any person for cancer, or to prescribe any remedy therefor, or to give any advice in connection with the treatment thereof.”

It is worth noting from the outset that this law applies to all forms of treatment, conventional or alternative, proven or unevidenced, scientific or superstitious.

Given this law, it is rather odd that Dr Stephen Hopwood has recently set up the Totnes Cancer Health Care Centre, an apparent spin off from his practice at the Artcurus Clinic.

Totnes is one of those towns that tries exceedingly hard to compete for the title of the “Most Alternative town in England”. Like some of its competitors, such as Glastonbury, it is a haven for alternative medicine and hosts its own Steiner school and a college that offers an MSc in ‘Holistic Science’. The Society of Homeopaths runs its ‘Education’ Department from here.

And Dr Hopwood indeed fits in very well here with his specialisms in acupuncture and Chinese Herbs. The Artcurus clinic employs the full range of alternative therapists including another doctor, Sarah Parker, who practices the absurd craniosacral therapy, Rowena Rowen with her emotional freedom skills, Caroline Baker, who uses something called Colour Mirror Oils, and other homeopaths, hypnobirthers, reiki therapists, reflexologists and energy healers.

The new Cancer Centre has been set up with nutritionist Barbara Wren and ‘world-renowned’ psychic healer, Matthew Manning. The Clinic promises to “establish your individual needs, build a personal programme and refer you to the appropriate practitioners”. The various techniques will “increase your ability to return to complete sustainable health.” and are “well founded in good science, extensive research and rational analysis”. I see no evidence from the treatments offered that this is true.

But then, Dr Hopwood would probably see me as part of a big conspiracy against ‘natural medicine’. The site contains a warning against the evils of mainstream medicine, how their ‘synthetic drugs’ have huge side-effects, and how there is a “war” on natural forms of treatment.

Hopwood is indeed an interesting character. His ideas about conspiracies are not limited to medicine. Indeed, he heads the “Totnes Truth Movement”, an organisation devoted to exposing how the 9/11and 7/7 attacks were performed by shadowy government forces and how global warming is just government propaganda designed to enable more control and taxes. He is a producer for a TV channel called BBC5 (showing you the stuff that the propaganda channels of the BBC will not show you). BBC5 broadcasts conspiracy documentaries, including the Burzynski movie.

Later this month, the Cancer Health Centre is holding a conference in Totnes with an interesting list of speakers. Attendees will have the pleasure of listening to Dr Tullio Simoncini, who believes cancer is a fungus and can be treated with baking soda and who was struck off in Italy and convicted for wrongful death and swindling, Dr. Robert Verkerk who runs the Alliance for Natural Health, a vitamin pill industry lobby group, and Dr Sarah Myhill, who has recently been battling with the regulators after she was forbidden from prescribing during an investigation into questionable claims on her website.

But so what? Leaving aside the issue of whether all this falls foul of the Cancer Act, surely people have a right to choose to believe in these superstitious and pseudoscientific forms of cancer treatment if they wish? And surely people who have little hope from conventional medicine should not be denied these alternatives?

As the father of a daughter of a little girl with an incurable cancer said today about his decision to send her to the very questionable and hugely expensive Burzynksi cancer centre in Texas, “My daughter needs the best chance to survive, and conventional medicine cannot give this. Does the money ultimately matter? It is the opportunity to try to save her life that is important, whatever the cost.”

This form of argument is very alluring. And indeed, I see similarities with the argument that you should believe in God, even if you have severe doubts as the reward of an eternal life is too big to ignore. This sort of argument is a quack’s form a Pascal’s Wager:

that since the existence of God can not be proved (or disproved) through reason, but since in his view there was much to be gained from wagering that God exists (and little to be gained from wagering that God doesn’t exist), a rational person should simply wager that God exists (and live accordingly).

As such, if I put myself in the pace of someone with cancer, I have nothing to lose from trying unevidenced treatments and everything to gain if they actually turn out to work. But, I would suggest, this argument falls apart in the same way that Pascal’s wager falls apart.

Pascal’s wager says nothing about which god I should believe in. Since there are many claims to religious truth, how do you know which god or gods you should believe in? Since belief in Zeus is not compatible with your belief in the Abrahamic god, how do you decide? The answer is you cannot. All gods can neither be proved or disproved therefore all are equivalent from this wager’s perspective.

If was dying, there would be hundreds of unevidenced and dubious claims as to how I should try to heal myself, and so how should I decide how to spend my limited time and money? Homeopathy, acupuncture, herbalism, miracle cures from the US, ozone therapy, a myriad of anti-cancer diets, B17, and on and on.

Unlike the religious version of the wager, I can keep trying another therapy if the last one turned out to be futile. This argument risks putting me on a treadmill of false hope and unable to get off.

The escape from this hell is to recognise that my life is not the only factor in how I make decisions. I must also take into account the lost opportunities I will be having as I pursue the dream of a cure at all expense. I must recognise the cost and effects on my family. If I choose wrongly here and invest my savings and time in the wrong protocols, that will impact those who survive me.

I would argue that it is quite rational to decide that since there are no good reasons for any of these approaches – and all will deprive me of time and money, and I am better off concentrating on living my life to the full right now, as best I can given my condition. Indeed, over the years I have been writing this blog, I have had a number of letters from the partners of those with cancer who describe the aftermath of the futile search for a cure in the New Age promises of alternative medicine. Precious months were wasted on the chase. Time that could have been spent with family. And only when it was just too late, was it realised what had been missed.

And this is why I think the Cancer Act is a vital protection. Those with cancer are not in a position to be good consumers of health care choices. Informed consent and measured choice is difficult to achieve when the overbearing pressure of imminent death looms. The allure of another chance, no matter how slim, will always drive towards the futile.

That is not to say that there cannot be a role for complementary therapies in cancer care. But the approaches I would advocate would not be based on superstition and conspiracy, would not generate false hope, would support me and my family at the gravest of times and would not empty a bank account at a time of great need.

The tragedy of alternative medicine is its total failure to find an ethical role for itself. By clinging to its delusions, it risks creating only overall harms. And, as such, it appears that legislation is the only way to protect people. If only Trading Standards were a little bit more on the ball in implementing existing laws.

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Now 78 and having worked in the cancer research field for all of my life I will say now that the work I have done did not save my wife from the effects of breast cancer nor would I have expected it too having been part of a heavily controlled and manipulated treatment plan.
One day it will all immerge about the truth of how results were hidden and re interpreted to suit the careful drug responses that are now used to interact with cancer and not necessarily cure it.
Even in the laboratory we were not allowed to try out any drug or compound that was not produced outside of the Chem. Medical industry.
There are probably more cures available for than we realise but were not going to be allowed to find them under the present rulings. Mesenchymal stem cells was my last research area.

“Those with cancer are not in a position to be good consumers of health care choices. Informed consent and measured choice is difficult to achieve when the overbearing pressure of imminent death looms. The allure of another chance, no matter how slim, will always drive towards the futile”.

Andy to say that is absolute rubbish, to say something like that I dont believe you have met many terminally ill people. The ones I know, and I know quiet a few, would be furious to be told “we dont think you can be a good consumer of health care” . In fact I would go as far as saying, your view is contrary to the entire approach to cancer care in the health service. I am sure there are people who get ripped off by fraudsters, they do tend to get prosecuted by the police. If you have evidence of charlatans operating in the UK offering misleading information about curing cancer lets hear it? This is not a common occurrence in the UK as you seem to be implying. The experience of cancer is different for everybody but your comment is insulting and ill informed. One of the best cancer centres in the country for teaching people how to live with cancer is the Penny Brohn Cancer Centre in Bristol. I spent three days there during the Summmer, guess how much it cost for three days £1,000, £500, £0. 0£ thats how much, they are a charity providing a service for terminally ill people which is not available anywhere else. No one is being forced to goi there against there wishes and they are not going there expecting to be cured. They do want to be empowered to be able to live with cancer and it does that very well.

In a months time I finish chemo, no one knows whether my cancer will return, I have a 50/50 5 year survival which my doctors believe has been improved by 6 months of chemo.What should I do now to stack the survival odds in my favour. Listen to family and friend who have found this ordeal hardest to deal with and let them decide on what I should do to try and prevent the cancer returning. They are the ones who are desperate for a cure and most likely to get ripped off. You see dying is easy, its harder for those who are left behind and usually they are the ones most scared. My young kids are the ones who have helped me most through this, their world does not stop because I have cancer. My five year old asked me if she could have my lap top if I died. It made me laugh. Shit happens and you get on with it, you dont become an idiot incapable of making decisions because you have cancer?

Let me make my position clear. I am not saying that people are not free to make their own choices in care and treatment when it comes to cancer. My blog here is about support of the Cancer Act 1939 and how it helps people from being bombarded by a huge number of unevidence (or indeed evidenced) claims at a time when the pressure to do something is understandably enormous.

Because of this overwhelming imperative to act, I would argue that the normal laws of the ‘market place of choice’ break down. The Cancer Act is a deliberate attempt to ensure that the choices made are more likely to be mediated and assisted by professional people whose job it is to understand cancer and what treatments are available.

It is very easy to fall for alluring stories about cure. The Penny Brohn Centre is famous for changing its name a number of years ago after a study showed that women attending there had worse outcomes. That was hugely unexpected – as the place offered a caring and compassionate space – but the evidence suggested that the compassion may not have been enough. Indeed, the clinic was enabling patients to undergo a number of unevidenced diets and treatments – as my girlfriend of the time was doing.

They concluded,

“While it is possible that BCHC attenders may, in some subtle way, have worse disease than our control series, the possibility that some aspect of the BCHC regimen is responsible for their decreased survival must be faced. For example, does radical adherence to a stringent diet shorten life in patients hose survival is already threatened by cancer?” Our study certainly shows that patients choosing to attend the BCHC do not gain any substantial survival benefit. Whether quality of life is enhanced is yet to be answered. Other alternative practitioners should have the courage to submit their work to this type of stringent assessment.”*

The compassionate advice that was being discussed may have been doing harm. People’s intentions are not enough. And understanding how to interpret claims and evidence is not easy – especially hard when the clock is ticking.

And, as always Richard, all the best.

* Just to note that I know the Bristol study has been criticised and has flaws. Of course – and I write the conclusions to show he reports nuanced conclusion and not just the detractors summary.

Andy is it so hard for you to admit when you are clearly wrong and don’t know what you are talking about. You state:

“Let me make my position clear. I am not saying that people are not free to make their own choices in care and treatment when it comes to cancer”.

Thanks for that, so “your position” is: cancer patients are “free to chose” the treatment they want, but we should not, because in your opinion:

“Those with cancer are not in a position to be good consumers of health care choices. Informed consent and measured choice is difficult to achieve when the overbearing pressure of imminent death looms. The allure of another chance, no matter how slim, will always drive towards the futile”

They are you words correct me if I am wrong is this not your position on the subject you are blogging about.

Can you not see how patronising and insulting these comments are to people who are terminally ill. Cancer is a physical illness it does not mean we become stupid and gullible overnight and need a merry band of sceptics to protect us from snake oil salesmen.

You say “The Cancer Act is a deliberate attempt to ensure that the choices made are more likely to be mediated and assisted by professional people whose job it is to understand cancer and what treatments are available”

This comment made me laugh because I know what you are thinking. In fact I am writing a book about this. Who are these people whose job it is to “understand cancer”, probably the best in the health service are the MacMillan nurses, but without a shadow of doubt the people who understand cancer the best, are the people who have cancer. Understanding cancer has littler to do with treatment and evidence and you comments just show your ignorance of the subject.

Then your hole gets deeper when you state “The Penny Brohn Centre is famous for changing its name a number of years ago after a study showed that women attending there had worse outcomes” Do you ever feel embarrassed when you spout absolute crap. Is that why you think they are famous for?

The Bristol Cancer Cetre changed their name to the Penny Brohn Centre in tribute to their founder Penny Brohn who died in1999. The Penny Brohn centre does not charge people so its not ripping any body off, which kind of does blow a hole in your theory. The centre does not talk about curing cancer, they talk about empowering people to live with cancer. Dont you think its important for patients to have “experts” help teach others how to live with cancer. I was there for three days during the Summer, its not for me, for reasons I wont go into here (read my book) . However I am in no doubt the vast majority of people do get enormous help from the centre.

The study you refer to did not compare like with like. The vast majority of people who go to Penny Brohn are terminally ill, they have been told by there doctors there is nothing more to be done. I was in a group of 12, I was the only person not terminally ill). There are told to go home and get their affairs in order. Think about it, a lot of people who present to the NHS are stage 2,3 with vast better survival chance than those who go to Penny Brohn. This was an appalling piece of research, I don’t know of any credible oncologist who would quote from it. I suppose skeptics my not have the training. Oh dear ad hom attack, just slipped out.

So it is not surprising to someone with an MSc in Health Promotion (Brunel); “that patients choosing to attend the BCHC did not gain any substantial survival benefit” then researchers asked “Whether quality of life is enhanced is yet to be answered”

If you knew anything about this subject you would know, that most medical cancer centres now recognise that the Penny Brohn approach does in fact improve “quality of life” and they are now offering complementary therapies, diet and exercise to their patients as Penny advocated to my mother back in 1988. As presumably is this guy you have tried to belittle in your blog post.

As a matter of interest, do you completely reject the current medical approach to treating cancer. Because restricting treatment to RCT evidence, would practically eliminate surgery, not sure chemotherapy passes the skeptic tests level of certainty, for it to be considered an effective treatment for cancer. Then there is experimental treatment, based on a theory, would sceptics allow that?

Richard, as a chiropractor you are clearly an advocate of so-called complementary and alternative medicine. I would be too, if it was genuinely complementary and could be shown to benefit people with cancer.

But as I make clear, what people most often get is unevidenced nonsense that actually undermines their understanding of medicine. Look at the speakers at this conference – a struck-off doctor who thinks cancer is a fungus and can be cured by baking soda. What is complementary about that?

An, again, as I make clear. I quote directly from the Bristol report so as not to be misrepresented – it is a false assumptions to assume that because a complementary approach is caring that it does net good. The Bristol report is interesting because it challenged very directly that assumption (and yes it was offering terrible quack diets – I know from direct experience.) Quacks have been very keen to misrepresent the conclusions of that report and denigrate it – but its actual conclusions are quite modest. As a piece of science, it recognises its weekenesses – and quacks have exploited that fully.

And finally, I am a little fed up with you misrepresenting my supposed views about RCTs. I have never advocated that RCTs are the only acceptable benchmark to test treatments. Treatments should be based on sound rationales and good evidence. It just so happens that RCTs make a very good sort of evidence – and if a treatment is capable of being tested by an RCT and fails to, then we should quite rightly question it.

“Those with cancer are not in a position to be good consumers of health care choices. Informed consent and measured choice is difficult to achieve when the overbearing pressure of imminent death looms. The allure of another chance, no matter how slim, will always drive towards the futile”

Her father has since died of cancer (six months after diagnosis), having wasted a significant part of his life savings on following the worthless advice of the quack who runs Cancer Options. She must be one of the most evil people alive.

Richard, do you deny that cancer patients are under peculiar pressure to seek out treatment to extend their lives? That they are seems logically obvious to me.

Are patients well-placed to distinguish valid medical therapies from quackery? If so, what gives them that ability? Everything we know about the nature of the fallacious thinking that underpins quackery tells us why people find it so easy to be sold untruths.

If cancer patients are not under peculiar pressure and reliably recognise quackery, why do so many quack cancer therapies flourish?

You assert that there is no opportunity cost merely because an organisation charges its patients no money. That is also not logically sound. There an obvious opportunity cost if people donate money to organisations promoting useless therapies and a further corrosive effect on the public understanding of science.

I didn’t know you have cancer and am sorry to hear it, but you seem happy to discuss it in public and defend a particular viewpoint and say cancer patients are not rendered stupid by their diagnosis so I hope you you are happy to answer just as if the disease did not affect you personally.

I find it particularly distressing when parents select these “alternative” cancer treatments for their children. I have no doubt that the parents in question love their child desperately, but because they cannot bear to think of their child dying, they try anything, and the result is that the poor child is subjected to all kinds of procedures. As you point out, this means that the family is deprived of having good quality experiences in the remaining time they have together. One case that is really upsetting is Billie Bainbridge, the little girl who was the centre of a storm when featured in the Observer because the family were trying to raise funds so she could go to the notorious Burzynski clinic for treatment. According to her diary, she is still on the Burzynski treatment, but is also receiving homeopathic remedies (at least harmless), a restricted diet (at a time when she might otherwise be indulged), and long trips to St Austell for hyperbaric oxygen treatment – a treatment that, as far as I know, is not even recommended for cancer. See http://www.billiebutterflyfund.org/billies-diary/
I hate to criticise parents who must be undergoing a hellish time, but I just despair that there are people out there who are willing to go along with this, and don’t just tell the parents to give their child as good a time as they can.

Not only the woo treatments, but they are still asking for more money for future expenses and treatments. That, despite the fact that they managed to raise 104% of their target: 209,000 pounds (sorry, don’t know how to make the “pounds” symbol on my North American keyboard).

“Richard, as a chiropractor you are clearly an advocate of so-called complementary and alternative medicine”

Andy, the fact I am a chiropractor is bolox in relation to what I am saying here.Is that what Skeptics call an Ad Hom or something.

You say I misrepresent your understanding of the role of RCTs in clinical science. Tell me then, do you have any qualifications in the subject or is it what you have picked up on the internet. I have a MSc in Health Promotion from Brunell, does that count for anything in Skeptic world, even had to write a research dissertation to pass and it wasnt on CAM.

I am a cancer patient who is receiving excellent medical treatment. Last week one on my chemo drugs was pulled on the grounds it might effect my movement, and being an active person it was felt my recovery and prevention was better served by the maintaining my current lifestyle. This was 100% a decision by an experienced oncologist at the Royal Marsden nothing to do with evidence of the efficacy of the chemo drug Oxypalin..?No one knows whether I will survive or how to prevent my cancer comming back. I accept that and do what makes sense to prolong and enhance the quality of my life.

Badly Shaved Monkey asks?” do you deny that cancer patients are under peculiar pressure to seek out treatment to extend their lives”.

It depends on the individual, when I see kids waiting for treatment, I think how lucky I am, I have had a great life wonderfull family and kids who tell me they would rather have me for ten years than an arsehole for 30 years. Its about quality of life, I hope in ten years that I can say I am glad I had this experience because its made me a better person and a better clinician.

If not my passing matters little in the whole scheme of things, dying is easy its hard for those left behind and I feel sorry for my friends and family who will miss me especially my kids. I have no regrets and dont fear the future at all.

I would say cancer is different for everybody, how they respond and the decisions they make. If my child had cancer I would go to the ends of the earth in search of a cure, and if I had not explored ever avenue I would feel I had let my loved one down. You guys seem to see this as a people making a choice between conventional cancer care and CAM. I have not met anyone who has rejected the medical approach to cancer and chose CAM instead, if I did I would say they were foolish.
.
Where I differ is when the doctor tells the patient, there is nothing more conventional medicine can do, go home and get you affairs in order.Should they do go home and die or resist, my personal view is thats for the individual to decide and they dont need skeptics help at arriving at their decision. Its a matter of personal choice and amateurs should keep out of the decision making process

Richard Lanigan wrote:
“Should they do go home and die or resist, my personal view is thats for the individual to decide and they dont need skeptics help at arriving at their decision.”

So you don’t see any need for legal protection from medical fraudsters, in the way you are legally protected from financial fraudsters (or product fraud, under the Consumer Protection Act or Trading Standards, etc.).
You believe medical fraudsters (which is practically all so-called “alternative medicine”) should have free reign to scam whoever they like. It’s right there in your post.
You believe in the freedom to sell false hope to terminally ill people, but I’ll bet you think it’s right that Bernie Madoff is in prison.

I’ll bet also that, were you up in front of a Judge, accused of a crime you didn’t commit, you’d expect the Court to rely on actual evidence rather than anecdote and heresay. I rather expect you’d want your forensic evidence to be scientifically based rather than “alternative forensics” relying alchemy or sympathetic magic.
Why the double standards?

Integrated, as well as. You do talk total bollocks. A patient cured is a customer lost. Don’t comment on things you have no personal experience of. Take your chemo, eat more sausages morons. http://www.youtube.com/watch?v=K6JsCXjS8lg

But, would you not agree that by buying into a whole host of discredited or poorly evidenced therapies you become a lucrative source of revenue to a large number of organisations promoting and profiting from these therapies? This is the Pascal’s wager that Andy describes.

Andy, if it wasn’t such a serious subject your views on ‘alternative’ treatments for cancer and your blanket discrediting of all non conventional treatments would be laughable. I use the word discrediting loosely because you never actually give any evidence against it! You just criticise and insult those who are suffering from cancer and have done some research. I challenge you to study the history of research into Vitamin B17 and its purified form Laetrile. This is research going back to the very early 20th century and is proven. There is no grey area…. The benefits of B17 and Laetrile is proven. The outright fraud and crminal withholding of this information from the public is jaw – dropping! ! How many eminent doctors, surgeons and scientists have been branded as ‘quacks’ when they have spoken out and used Laetrile successfully with their patients. I am not a medical doctor, nor a scientist and neither are you, but I have read many books on the subject and I base my views on the evidence. You have an agenda to debunk using all tools at your disposal. For example, what does someone’s views on the events of 911 have to do with their views on medicine!! If you have to resort to ad hom attacks it just reveals your lack of confidence in your argument. Your remit is to be the Skeptic and you do a great job at that. Thankfully most people are more open-minded.

You are still presenting no proof that there is no cure for cancer. The onus is on YOU to present the evidence that the historical record of studies on Vitamin B17 for example and the amazing results it has produced is inaccurate or fraud. In the process you would have to discredit many highly accomplished physicians and scientists, including eminent oncologists who dedicated their life’s work to finding a cure for cancer.

ALL terms are invented Andy. And surely, the purpose of this website should be to provide evidence for or against ‘laetrile’ etc. After all, isn’t it supposed to be a ‘public service’?

Andy Lewis

October 9, 2014 at 9:55 am

Yes, but some terms have specific meaning. Vitamin is one such term. Laetrile is not a vitamin even if you call it Vitamin B17.

As for the purpose of this web site, I shall decide that and not you. And one purpose of this web site is to explain why you should not believe people who make claims for medical treatments without themselves bothering to provide the evidence. Like you.